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Allogeneic hematopoietic cell transplantation for acute myeloid leukemia with hyperdiploid complex karyotype

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Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) remains the best consolidation strategy for acute myeloid leukemia (AML) with complex karyotype (CK). However, CK is a heterogenous and highly diverse entity. Numerical abnormalities have been associated with a controversial prognosis and AML with only multiple numerical abnormalities known as pure hyperdiploid karyotype (HDK) may have a distinct prognosis after allo-HCT compared to non-pure HDK CK AML. A total of 236 patients were identified within the EBMT registry as having HDK comprising 95 pure (pHDK) and 141 with other cytogenetic abnormalities (HDK+). The 2-year probability of leukemia-free survival (LFS) was 50% for pHDK and 31% for HDK+ (p = 0.003). The 2-year probability of overall survival (OS) was 57% for pHDK and 36% for HDK+ (p = 0.007). The 2-year cumulative incidence of relapse (RI) was 22% for pHDK and 44% for HDK+ (p = 0.001). The 2-year probability of graft-versus-host disease (GvHD)-free and relapse-free survival (GRFS) was 36% for pHDK and 21% for HDK+ (p = 0.01). On multivariate analysis, pHDK remained associated with significantly better LFS, OS and GRFS and lower RI (all p-values <0.004). pHDK AML constitutes probably a distinct cytogenetic entity from HDK+ or other non-hyperdiploid CK AML with better outcomes after allo-HCT.

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Fig. 1: Relapse Incidence (RI), Leukemia-free survival (LFS), non-relapse mortality (NRM) and overall survival (OS) by cytogenetic groups.

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Data availability

The datasets analyzed during the current study have been generated from ProMISe (Project Manager Internet Server), the international database coordinated by EBMT.

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Author notes

  1. These authors contributed equally: Arnon Nagler, Jordi Esteve, Mohamad Mohty.

Authors and Affiliations

  1. Section of Hematology, Institut Roi Albert II, Cliniques Universitaires St-Luc, Brussels, Belgium

    Xavier Poiré

  2. Acute Leukemia Working Party of the EBMT, Paris, France

    Myriam Labopin, Emmanuelle Polge & Mohamad Mohty

  3. Université Pierre et Marie Curie, Paris, France

    Myriam Labopin, Emmanuelle Polge & Mohamad Mohty

  4. INSERM UMR 938, Paris, France

    Myriam Labopin, Emmanuelle Polge & Mohamad Mohty

  5. Service d’Hématologie, Hôpital Saint-Antoine, Paris, France

    Myriam Labopin, Emmanuelle Polge & Mohamad Mohty

  6. Hannover Medical School, Hannover, Germany

    Arnold Ganser

  7. Department of Hematology, Bone Marrow Transplantation, Hôpital Saint-Louis, Paris, France

    Gérard Socié

  8. Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Tobias Gedde-Dahl

  9. CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France

    Edouard Forcade

  10. Universitätsklinikum Freidburg, Department of Medicine, Hematology, Oncology, Freidburg, Germany

    Jürgen Finke

  11. Hôpitaux Universitaires de Genève, Département d’Oncologie, Service d’Hématologie, Genève, Switzerland

    Yves Chalandon

  12. CHU Grenoble-Alpes, Université Grenoble-Alpes, Grenoble, France

    Claude-Eric Bulabois

  13. CHU de Lille, Université de Lille, INSERM U1286, Infinite, 5900, Lille, France

    Ibrahim Yakoub-Agha

  14. King Faisal Specialist Hospital & Research Center, Section of Adult Haematology/BMT, Riyadh, Saudi Arabia

    Mahmoud Aljurf

  15. University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany

    Nicolaus Kröger

  16. Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Charité Universitätsmedizin, Berlin, Germany

    Igor Wolfgang Blau

  17. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Arnon Nagler

  18. Hematology department, Hospital Clinic, Barcelona, Spain

    Jordi Esteve

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  1. Xavier Poiré
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Contributions

XP, AN, JE and MM wrote the manuscript; XP, ML, AN, JE and MM designed the study; XP, ML, AN, JE and MM analysed the data; EP, AG, GS, TGD, EF, JF, YC, CEB, IYA, MA, NK and IWB provide the data and reviewed the manuscript.

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Correspondence to Xavier Poiré.

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Poiré, X., Labopin, M., Polge, E. et al. Allogeneic hematopoietic cell transplantation for acute myeloid leukemia with hyperdiploid complex karyotype. Bone Marrow Transplant 59, 264–269 (2024). https://doi.org/10.1038/s41409-023-02167-1

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